Comparison of Cormatrix? porcine extracellular matrix and pericardial patch augmentation for tricuspid valve leaflet reconstruction - A singlecenter experience.

Abstract

Background and aim: Leaflet augmentation to treat restrictive mitral leaflet motion in type IIIB mitral regurgitation is well-known. Leaflet augmentation of the tricuspid valve is less well described. The aim of this retrospective study was to assess short- and long-term valve function and patient outcome in all patients receiving tricuspid valve leaflet augmentation with either Cormatrix or bovine/autologous pericardium in our institution from 2007 to 2016. Materials and methods: NYHA class, diagnosis, type of surgery and health state were found through chart review. Echocardiography exams before surgery, 1 month after, 6 months after, and latest exam were analyzed regarding biventricular function, valve function, leaflet mobility and –thickness. Results: In eight patients; Cormatrix (n=4), bovine pericardium (n=3), and autologous pericardium (n=1) were used for 7 anterior leaflet extensions and 1 septal leaflet extension. Follow-up ranged from 6 to 132 months. Three patients had died, two in the Cormatrix group, and one in the pericardial group. Over time, coaptation length (12 ± 5 mm vs. 8 ± 3 mm, p=0.03) decreased significantly in the Cormatrix group, while none of the other parameters differed significantly. A tendency towards reduced leaflet mobility and thickening of the pericardialextended leaflets were seen over time. Conclusion: Cormatrix and pericardium as patch material for tricuspid leaflet extension are comparable regarding valve performance and durability of the repair in this study, though resorption of Cormatrix material seems to take place leading to decreasing coaptation height. This is a sign of tissue remodelling. Leaflet mobility was reduced in the pericardial repair group and may likely be related to thickening of pericardial patch material that occurred over time.